经支气管镜大容量肺灌洗治疗尘肺病合并慢性阻塞性肺疾病的疗效分析

目的评价经支气管镜大容量肺灌洗对尘肺病合并慢性阻塞性肺疾病(COPD)患者的临床症状及肺功能的改善作用。方法 103例尘肺病合并COPD患者随机分为治疗组54例,给予经支气管镜大容量肺灌洗治疗,对照组49例。观察患者治疗前、治疗后12、24和48周运动耐量、呼吸困难评分、6 min步行试验距离(6MWD)、圣乔治问卷评分(SGRQ)以及肺功能变化。并记录灌洗时的不良反应。结果两组患者第12、24和48周医学研究委员会(MRC)呼吸困难评分均较治疗前下降(P <0.05),但治疗组较对照组下降更明显(P <0.05);治疗组各时点6MWD值较前明显增加,SGRQ较治疗前下降,差异均有统计学意义(P <0.05),而对照组有所改善,但与治疗前比较差异无统计学意义(P>0.05);治疗组中各项指标较对照组改善(P <0.05)。治疗组12、24和48周用力肺活量(FVC)、第1秒用力肺活量(FEV1)均较治疗前明显增加(P <0.05);对照组与治疗前比较无差异,治疗组肺功能改善优于对照组(P <0.05)。结论经支气管镜大容量肺灌洗治疗尘肺病合并COPD安全、有效,值得临床推广。

Protective effects of edaravone on diffuse brain njury in rats

BACKGROUND：Edaravone can alleviate brain injury and improve neurological functions and symptoms. This study aimed to investigate the effect of edaravone on the p38Mitogen-activated protein kinases/Caspase-3 （p38MAPK/Caspase-3） pathway after diffuse brain injury （DBI） in rats. METHODS： DBI models were established according to the description of Marmarou＇s method. A total of 250 rats were divided （random number） into four groups： control group （CG, n=45）, model group （MG, n=77）, low-dose edaravone group （n=67, dosage 5 mg/kg） and high-dose edaravone group （n=61, dosage 10 mg/kg）. After 1,6, 24, 48, and 72 hours after injury, brain tissues were collected. The changes of neuron morphous in the hippocampal region were observed through Nissl staining. The expression levels of phosphorylated p38MAPK and caspase-3 were detected by immunohistochemistry and Western blotting respectively. Learning and memory function were tested with Morris water maze from the 3rd to 7th day after injury. RESULTS： Some neurons had histopathologic changes of necrosis and apoptosis in the model group compared with the control group. The phosphorylated p38MAPK expressions increased at 1,6, 4, and 48 hours （P〈0.05）, but no significant difference was observed at 72 hours （0.54±0.19 vs. 0.40±0.14, P〉0.05）. Caspase-3 expressions increased at 6, 24, 48, and 72 hours respectively （P〈0.05）, but there was no significant difference at 1 hour （0.59±0.29 vs. 0.40±0.17, P〉0.05）. From the 3rd to 6th day during the Morris water maze test, the latency to find the platform was significantly prolonged （P〈0.05） and times of rats crossing the platform was decreased on the 7th day （2.28±1.18 vs. 8.20±1.52, P〈0.05）. The phosphorylated p38MAPK expressions decreased at 6, 24 and 48 hours respectively in the low dose edaravone group compared with the model group （P〈0.05）, whereas no significant difference was seen at 1 hour （1.66±0.80 vs. 1.85±0.86, P〉0.05）. Caspase-3 expression decreased at 6, 24, 48, and 72 hours （P〈0.05）. The latency to find the platform was significantly shortened （P〈0.05）, and times of rats crossing the platform increased （4.17±1.15 vs. 2.28±1.18, P〈0.05）. The above mentioned parameters changed more significantly in the high-dose edaravone group than in the low-dose edaravone group. CONCLUSION：Edaravone can alleviate brain tissue damage after DBI, inhibit p38MAP signal activation after early injury, reduce the expression of caspase-3, and promote the recovery of neurological function in the late period.

Maisonneuve injury with no fibula fracture:A case report

BACKGROUND Ankle syndesmosis injury is difficult to diagnose accurately at the initial visit.Missed diagnosis or improper treatment can lead to chronic complications.Complete syndesmosis injury with a concomitant rupture of the interosseous membrane(IOM)is more unstable and severe.The relationship between this type of injury and Maisonneuve injury,in which the syndesmosis is also injured,has not been discussed in the literature previously.CASE SUMMARY A 16-year-old patient sustained left medial malleolar fracture,and the associated inferior tibiofibular syndesmotic instability was overlooked.After open reduction and internal fixation of the medial malleolar fracture,inferior tibiofibular syndesmosis diastasis with IOM rupture was detected by auxiliary imaging.Secondary surgical intervention was performed to reduce anatomically and fix with two trans-syndesmosis screws.Twelve weeks later,the screws were removed.At the 6-mo follow-up,the patient gained full range of motion of the ankle.CONCLUSION Complete syndesmosis injury with IOM rupture should be considered Maisonneuve-type injury.Open reduction and internal fixation could obtain good outcomes.

BQ-123对蛛网膜下腔出血大鼠神经功能的保护作用研究

目的探讨BQ-123对蛛网膜下腔出血(SAH)的治疗作用及其机制。方法 160只雄性SD大鼠,随机分为假手术(Sham)组、SAH组、雷帕霉素组、低剂量BQ-123组、高剂量BQ-123组。2次注血法复制SAH大鼠模型;光镜观察海马区形态结构变化;免疫组织化学法检测海马区雷帕霉素靶蛋白(mTOR)、自噬相关基因Beclin-1和微管相关蛋白1轻链(LC3)-Ⅱ的表达;实时逆转录聚合酶链反应(real-time RT-PCR)检测mTOR、Beclin-1和LC3的mRNA表达;抓力测定实验评价各时间点大鼠前肢拉力情况;穿梭箱实验测试动物的学习功能。结果与Sham组比较,SAH组海马区mTOR、Beclin-1和LC3 mRNA表达增加,存活神经元细胞数量减少,大鼠的学习功能和拉力值下降,差异有统计学意义(P<0.05);与SAH组比较,雷帕霉素组海马区mTOR mRNA表达降低、Beclin-1和LC3 mRNA表达增高,存活神经元细胞数量增多,大鼠的学习功能和拉力值改善,差异有统计学意义(P<0.05);与SAH组比较,BQ-123组海马区mTOR mRNA降低、Beclin-1和LC3 mRNA表达增高,存活神经元细胞数量增多,动物学习功能指标和拉力值改善,差异有统计学意义(P<0.05),且上述变化在高剂量BQ-123更为明显。结论 BQ-123可改善SAH大鼠神经功能缺陷,抑制mTOR激活,从而提高海马区神经细胞自噬程度。

Multisystem involvement Langerhans cell histiocytosis in an adult:A case report

BACKGROUND Langerhans cell histiocytosis(LCH)is a rare condition wherein Langerhans cells proliferate abnormally,adversely impacting organs including lymph nodes,bones,skin,lungs,and pituitary gland.The LCH disease course varies widely among patients from a self-limiting condition to one that progresses rapidly and culminates in death.It is uncommon for multisystem LCH to be observed in adults.Herein we describe a woman suffering from multi-system LCH involvement.CASE SUMMARY A 37-year old Chinese woman was admitted to the hospital in June 2019 suffering from dyspnea that had progressed over the course of 5 years.Her medical history included:central diabetes insipidus(DI)that had been treated via radiotherapy,desmopressin acetate,and bromocriptine;bilateral pneumothorax with two surgeries having been performed to remove bullae;and autoimmune hepatitis that had been unsuccessfully treated using a combination of methylprednisolone and mycophenolate mofetil.A chest computed tomography(CT)scan revealed the presence of multiple pulmonary cysts of varying sizes.We re-analyzed right pulmonary bullae samples that had been removed in 2014,performed a systematic 18 F-FDG PET/CT analysis,and convened a multidisciplinary medical team to diagnose and treat this patient.As a result,we were able to eventually diagnose this patient with LCH that was not associated with BRAF-V600 E mutations.CONCLUSION We hope to emphasize the importance of systemic evaluation and of cooperation between multidisciplinary physicians with the goal of improving awareness and detection of this orphan disease.

Effect of siRNA interference on nerve growth factor in intervertebral disc inflammation rats

Objective:To investigate the inhibition effect of siRNA interference on NGF induced by inflammatory factor IL-6,and JUL—1 so as to provide novel targets for clinical treatment of discogenic low back pain.Methods:The intervertebral disc nucleus and annulus fibrosus cells of rats were separated-The cells were co-cultured with different concentrations(10 nmol/L,20nmol/L,50 nmol/L,100 nmol/L)of IL-6 and IL-1β.The NGF-siRNA was leaded into the cocultured cells with its import ability assessed by flow cytometry instrument tests,hefore and after which the NCF mRNA expression was detected by real-time Q-PCR and the NGF content was detected by ELISA.Results:Flow cytometry instrument test results showed that the NGFsiRNA cell conversion rate was 99.8%.Real-time Q-PCR detection results showed that compared with negative control group,the NGF mRNA expression of co-cultured cells treated by 10 nmol/L,20 nmol/L,50 nmol/L,100 nmol/L IL-6 and IL-1βwere respectively raised 3.4,3.7,4.7,3.7 times which were all significantly down-regulated after the import of NGF-siRNA.EILSA detection results showed that compared with negative control group,the NGF content of cocultured medium treated by 10 nmol/L,20 nmol/L,50 nmol/L,100 nmol/L I-L6 and IL-1βwere respectively raised 2.9,3.3,4.5,7.4 times which were all significantly decreased after the import of NGF-siRNA.Conclusions:These molecular biological results suggest that inflammatory factor IL-6 and IL-1βcould stimulate NCF on intervertebral disc cells in vitro culture model and its efficiency is concentration dependent,while siRNA interference can inhibit the stimulation effect of IL-6 and IL-1βon intervertebral disc cell,which provides a new targets for the clinical treatment of discogenic low back pain.

Effect of invigorating kidney and invigorating bone decoction on sex hormones and cytokines in women with postmenopausal osteoporosis

Objective:To investigate the effects of Bushen Jiangu decoction (kidney invigorating and bone invigorating decoction) on sex hormones and cytokines in women with postmenopausal osteoporosis (PMOP).Methods:From February 2014 to May 2016, 98 PMOP patients were selected as the research objects, randomly divided into observation group and control group (n=49). Two groups were given oral alendronate 70 mg/ times, 1 time/week, Caltrate D 1 tablets, 2 times/d. The observation group was given Bushen Jiangu decoction, daily 1 agent. The treatment period was 6 months. The fasting peripheral venous blood was collected before and after treatment and analyzed by automated chemiluminescence immunoassay analyzer for determination of serum estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH), prolactin (PRL), testosterone (T) and type I collagen carboxy terminal peptide (CTX), type I precollagen (PINP);using radioimmunoassay method of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), insulin-like growth factor (IGF-1).Results:The E2 and T levels of the observation group after treatment were significantly increased compared with before treatment (P<0.05). The IL-6 and TNF-alpha of the observation group after treatment were lower than before treatment, while IGF-1 increased than that before treatment, significantly better than the control group (P<0.05);The CTX, P of NP of the observation group after treatment was significantly lower than the control group during the same period (P<0.05).Conclusions:The combination of Bushen Jiangu decoction combined with sodium hyaluronate can effectively improve the level of sex hormones in patients with PMOP, regulate the level of IL-6, TNF-alpha and IGF-1, inhibit the formation of osteoclasts and bone resorption, and improve the treatment effect of osteoporosis.

Searching for ^(76)Ge neutrinoless double beta decay with the CDEX-1B experiment

We operated a p-type point contact high purity germanium(PPCGe)detector(CDEX-1B,1.008 kg)in the China Jinping Underground Laboratory(CJPL)for 500.3 days to search for neutrinoless double beta(0νββ)decay of ^(76)Ge.A total of 504.3 kg⋅day effective exposure data was accumulated.The anti-coincidence and the multi/single-site event(MSE/SSE)discrimination methods were used to suppress the background in the energy region of interest(ROI,1989–2089 keV for this work)with a factor of 23.A background level of 0.33 counts/(keV⋅kg⋅yr)was realized.The lower limit on the half life of^(76)Ge 0νββdecay was constrained as T_(1/2)^(0ν)>1.0×10^(23)yr(90%C.L.),corresponding to the upper limits on the effective Majorana neutrino mass:<mββ><3.2–7.5 eV.

Simulation of the erosion of casing and perforation under staged sand fracturing conditions in horizontal sections

The new fracturing technology of intensive stages and high-intensity proppant injection shows significant advantages of cost reduction and high efficiency in the volume fracturing of unconventional reservoirs,but it also intensifies the erosion of the casing and the perforations,with a perforation diameter expansion and the casing wall thinning.To solve this problem,in view of the applications of the perforation fracturing technology under the construction conditions in Mahu Area in Xinjiang,China,the structure parameters of the downhole strings are measured and a calculation model of the perforation casing erosion is established for the large-displacement sand fracturing process in horizontal sections.The software ANSYS-FLUENT is used to simulate the casing and perforation erosion under different conditions of the displacement,the sand content,the proppant particle size,and the fracturing fluid viscosity in the sand fracturing process.The particle size of the proppant and the viscosity of the fracturing fluid mainly affect the erosion area,but they have little influence on the erosion rate.The sand content and the displacement significantly affect the erosion rate.Among these factors,the sand content has a more significant effect on the erosion rate and the displacement has a more significant effect on the erosion area.Due to the influence of gravity,the perforation erosion rate is larger when the phase angle ranges from 120°to 240°.

Effect of casting speed on dendrite arm spacing of Mn13 steel continuous casting slab

The dendrite arm spacing in the continuous casting slab of Mn13 steel under different casting speeds was measured using the metallographic microscope. Meanwhile, a heat transfer model was established by the Pro-cast software. The relationship between the dendrite arm spacing and casting speed in continuous casting slab of Mn13 steel was studied and described by a function expression. The results provide an important theoretical basis for the development and optimization of con-tinuous casting production process of high-manganese steel and help to improve the quality of continuous casting slab of high-manganese steel. Under the experimental conditions, the suitable casting speed is about 0.9 m/min. The secondary dendrite spacing maintains a relatively stable low-amplitude increase trend, and it is beneficial to obtain a higher proportion of equiaxed crystals.

Absolute measurement of radiant power for synchrotron radiation monochromatized X-rays

Purpose Absolute measurement of radiant power in the X-ray region is essential for many applications in astrophysics,spectroscopy,and X-ray diagnostics.This paper presents a dependable method of absolute measurement of radiant power for synchrotron radiation monochromatized X-rays.Methods A free-air ionization chamber was examined closely and employed as the detector in the present work.Its measuring principle was discussed,and the correction factors were determined.Absolute measurement of radiant power for synchro-tron radiation monochromatized X-rays in the region of 6-20 keV was performed using the free-air ionization chamber at Beijing Synchrotron Radiation Facility.As a verification and an important application,photodiodes were calibrated against the free-air ionization chamber.Results Relative standard uncertainties of absolute measurement using free-air ionization chamber are about 1%.Calibration of photodiodes within the photon energy range from 6 to 20 keV has relative standard uncertainties below 1.5%.Conclusion The free-air ionization chamber is qualified to be used in many disciplines to support the measurement of opti-cal radiation.